I am a junior faculty member in the Department of Critical Care Medicine at the University of Pittsburgh. I am trained in Pulmonary and Critical Care Medicine and have a Masters of Public Health degree. My short-term goal is to complement my existing training in clinical research with the experience of leading a moderately sized clinical study in the ICU and to learn additional techniques relevant to my long-term goal: conducting interdisciplinary translational research that will optimize long-term outcomes of critical illness. With the guidance of my mentor, Dr. Derek Angus (a member of my Department at UPMC), and key advisors, I have developed a set of formal coursework, directed reading and tutorials that will form the educational and training core necessary to achieve my goals. My research project, "Mechanical Ventilation and Delirium" is designed to both provide important new information and provide an important educational opportunity that compliments the other components of my career development plan. Delirium is a very common and serious complication of mechanical ventilation that is associated with increased duration of mechanical ventilation and ICU stay;increased medical complications, such as ventilator associated pneumonia;and poor patient outcomes, such as increased 6-month mortality and long-term cognitive deficits. While the poor outcomes associated with delirium have been defined, there is an incomplete understanding of how delirium should be managed as well as the pathophysiology that underlies it. No work has rigorously evaluated the current national guidelines that call for routine delirium screening and treatment with haloperidol, nor examined the contribution of brain injury and impaired central cholinergic transmission to the development of delirium. To address these issues, I will conduct a randomized controlled trial of haloperidol versus placebo in 304 delirious mechanically ventilated patients. This study will be nested within a larger cohort study of delirium pathophysiology in 380 mechanically ventilated ICU patients. The two components of this study represent a translational approach to tackling this problem. This work has the potential to significantly advance the understanding of delirium and inform future clinicians in the proper approach to delirium management while also serving as preliminary work for a future grant submission.